Swenson Karen K, Nissen Mary J, Ceronsky Carolyn, Swenson Lindsey, Lee Martin W, Tuttle Todd M
Park Nicollet Institute, Minneapolis, Minnesota 55416, USA.
Ann Surg Oncol. 2002 Oct;9(8):745-53. doi: 10.1007/BF02574496.
Axillary lymph node dissection (ALND) is often associated with permanent arm side effects. Side effects after sentinel lymph node dissection (SLND) should be less common, because the surgery is less extensive.
The study compared side effects and interference with daily life between 169 women who underwent an SLND and 78 who underwent an ALND for breast cancer. Patients rated symptom severity and interference with daily life caused by pain, numbness, limitation of arm range of motion (ROM), and arm swelling at 1, 6, and 12 months after surgery by using the Measure of Arm Symptom Survey. Repeated-measures and regression analyses for each time period were used to determine associations between symptoms and dissection type.
At 1 month, SLND patients reported less pain, numbness, limitation in ROM, and seromas than ALND patients. At 6 months, SLND patients had less pain, numbness, and arm swelling, and at 12 months, SLND patients had less numbness, arm swelling, and limitation in ROM than ALND patients. At 1 month, pain, numbness, and limitation in ROM interfered significantly more with daily life for ALND patients. At 6 and 12 months, only numbness interfered more with daily life for ALND patients.
SLND was associated with fewer side effects than ALND at all time points.
腋窝淋巴结清扫术(ALND)常伴有永久性手臂副作用。前哨淋巴结清扫术(SLND)后的副作用应较少见,因为该手术范围较小。
本研究比较了169例行SLND的乳腺癌女性患者和78例行ALND的乳腺癌女性患者的副作用及对日常生活的影响。患者在术后1、6和12个月时,使用手臂症状调查问卷来评估疼痛、麻木、手臂活动范围受限(ROM)和手臂肿胀所导致的症状严重程度及对日常生活的影响。对每个时间段进行重复测量和回归分析,以确定症状与清扫类型之间的关联。
在术后1个月时,SLND患者报告的疼痛、麻木、ROM受限和血清肿比ALND患者少。在术后6个月时,SLND患者的疼痛、麻木和手臂肿胀较少;在术后12个月时,SLND患者的麻木、手臂肿胀和ROM受限比ALND患者少。在术后1个月时,疼痛、麻木和ROM受限对ALND患者日常生活的干扰明显更大。在术后6个月和12个月时,只有麻木对ALND患者的日常生活干扰更大。
在所有时间点,SLND的副作用均少于ALND。